During the Procedure

During the procedure, doctors provide an agent to sedate the patient (such as midazolam (Versed) and /or a narcotic (for example, fentanyl), although the patient remains conscious (so-called conscious sedation "twilight sleep"). Recently, propofol (a short acting , intravenous hypnotic agent) has become more commonly used as an anesthetic agent for bronchoscopies. Lidocaine also can be used to anesthetize the patient's upper airways.

The patient will be monitored during the procedure with periodic blood pressure checks, respiratory rate, continuous electrocardiogram (ECG, EKG) monitoring of heart and oxygen measurement. Monitoring is extremely important in all forms of anesthesia.

The doctor can insert a flexible bronchoscope through either the nose or mouth. The patient can be either sitting or lying down.

Once the bronchoscope is inserted into the patient's upper airway, the doctor will examine the vocal cords. The doctor continues to advance the instrument to the trachea and on down, examining each area as the bronchoscope passes.

If doctors discover an abnormality, they may sample it, using a brush, a needle, or forceps.

Doctors can obtain a specimen of lung tissue (transbronchial biopsy) often using a real-time X-ray (fluoroscopy). This specimen contains actual lung tissue which may include samples of the air sacs, airways, blood vessels, and supporting membranes of the lungs.